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Class Certified Against Aetna and MCMC LLC on Behalf of Patients Battling Major Depressive Disorder

May 10, 2017

The United States District Court of the District of Connecticut has certified a class of plaintiffs in a Zuckerman Spaeder lawsuit alleging systematic mental health claim denials by Aetna Inc. and Aetna Life Insurance Company (collectively “Aetna”), and MCMC, LLC. This certification is part of a national effort, led by firm partners D. Brian Hufford and Jason Cowart, to hold insurance companies accountable to their obligations for treating mental illness and substance disorders.

In Meidl v. Aetna Inc., et al., plaintiffs allege that Aetna improperly adopted and implemented a policy to categorically deny insurance coverage for Transcranial Magnetic Stimulation (TMS) therapy as a treatment for Major Depressive Disorder. Plaintiffs allege that this policy violated Aetna’s fiduciary obligations under the Employee Retirement Income Security Act (ERISA). In its May 4, 2017 decision, the court granted the plaintiff’s motion for class certification and appointed Zuckerman Spaeder and Psych-Appeal Inc. to serve as class counsel.

“For years, insurers have used cynical legal strategies to avoid their obligations to patients with legitimate mental health claims,” said Hufford, co-lead counsel for the plaintiffs along with Cowart and Zuckerman partner Andrew N. Goldfarb. “But with this certification, and similar wins over the last two years, the tide may be turning. The courts are clearly saying that insurers can be held accountable, on a class-wide basis, for their systematic denial of mental health and substance abuse-related coverage. This is another step forward in our fight to give voice to patients who face illegal insurance barriers to life-saving care.”

The Zuckerman Spaeder effort gained significant momentum in August 2015, when the Second Circuit Court of Appeals delivered a pivotal win (New York State Psychiatric Ass’n, Inc. v. UnitedHealth Grp (Second Circuit Court of Appeals)) that rejected United Healthcare’s argument that it could not be held accountable because it was simply acting as a claims administrator. The court’s decision allowed ERISA action to be brought against the insurer under the Mental Health Parity and Addiction Equity Act of 2008. Following this, in September 2016, the U.S. District Court for the Northern District of California certified classes of plaintiffs challenging United Behavioral Health’s internal mental health and substance abuse-related coverage criteria (Wit et al. v. UnitedHealthcare et al. (D.N.J.) and Alexander et al. v. United Behavioral Health (D.N.J.).

Zuckerman Spaeder partners D. Brian Hufford and Jason Cowart have pioneered unique applications of ERISA to root out unlawful insurance company rules and procedures that drive so many decisions affecting patient health and provider reimbursements. This work has led to precedent-setting wins for health providers and two of the largest settlements of ERISA benefit class actions in history. Their work on behalf of mental health patients has gained high-profile support, including from the Department of Labor and former U.S. Rep. Patrick Kennedy, the author of the federal mental health parity act.